Future Misgivings

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The moment my eyes zeroed in on “This Is Not the Life I Ordered” during a rummage sale at Third Place Books, I knew I would buy it.  My heart responded with an immediate and emphatic damn straight! 

I know you’re not supposed to judge a book by it’s cover (or title), but in this case, I needn’t have worried.  “This Is Not the Life I Ordered” is written by four middle-aged women who, over the course of their lives, have experienced all manner of heartache – death, divorce, personal illness, unemployment – yet managed to maintain both their grit and sense humor.  I read it in a single sitting and promptly recommended it to friends.

I’ve often wished I could return my uterus to the dealership, like a lemon car, and get a better model.   The question “Why me?!” has been a common refrain throughout my attempts at motherhood – along with a belligerent belief that life should be fairer, and an occasionally tragic attitude.  I’m not saying I don’t have plenty be upset about.  I’ve worked (and continue to work) hard to process my grief, which I feel entitled to do.  However, there also came a point when rather than asking, “How did I get here?” I wanted to instead ask, “Now what?”

All of us at some point (or many points) in our life will be faced with circumstances we didn’t plan for or didn’t want.  These situations are disappointing, and frustrating, and often miserable; but they also afford us an opportunity to imagine a different future.

The book includes a quote by Ayn Rand, from “Atlas Shrugged:”

Do not let your fire go out, spark by irreplaceable spark, in the hopeless swamps of the approximate, the not-quite, the not-yet, the not-at-all.  Do not let the hero in your soul perish, in lonely frustration for the life you deserved, but have never been able to reach.

Admittedly, I have never read Ayn Rand, and I know little about objectivism as a philosophy, so I cannot speak to the true meaning of this quote or it’s context.  To me, it is a reminder not to buckle under the weight of life’s unrealized dreams – to challenge inflexibility and perfectionism.  Life will never look as we expect it to, but we can’t let that fact dull our spirit. 

In “Atlas Shrugged” the passage continues:

Check your road and the nature of your battle. The world you desired can be won, it exists, it is real, it is possible, it’s yours.

But I don’t think this means we can have whatever we want. Rather, I find the operative part to be “check the nature of our battle.”  The world we desire can be won, but only if we are clear what world we’re fighting for.

I ALWAYS wanted kids; I simply couldn’t envision a life without them.  The life I constructed as an adult was built with children in mind.  Without them, it felt purposeless. But my husband was cut from a different cloth.  He thinks kids will be fun and a wonderful way for us to grow together, but he has also always been able to picture a beautiful, full life for us without them.  Family for him is a choice, not a necessity. 

At first his perspective was not easy for me to accept.  I felt like I had to be the driving force behind our family planning.  Fertility treatments were exhausting and emotional; many times, I wanted to quit, but I worried he wouldn’t have talked me out of it.  Paradoxically, his permission to quit was exactly what I needed to move forward.

I felt ashamed of wanting to get off the baby-making treadmill.  I thought it meant I didn’t want kids badly enough and didn’t deserve to be a mother.  Core values about determination and work ethic conflated with my aspirations to be a mother and caused me to believe that if I wasn’t willing to do anything or try everything to have a baby, it meant parenthood wasn’t important enough to me.

Several people (including my mother and my therapist) tried to untangle my knotted emotions.  Others tried to solve the problem by reminding me I could “always adopt.”  Many offered words of encouragement or prayers.  But my husband held my hand while I left dreams behind and considered terrifying possibilities.  Instead of telling me we had to try again, he helped me imagine all the other things we could do with our life – travel adventures we could take, places we could live, relationships we could have with our nieces and nephews.  He made a life without kids seem okay.

I thought about people like my aunt Missy – my dad’s younger sister, the “cool aunt” of my childhood who lived in the city, traveled the world for work, and had a personal shopper.  But more than her “coolness” I thought about the role she played in my life growing up, as a trusted adult who I knew would always be there for me and who often felt more approachable than my parents.  Though she married later and never have kids of her own, I only admired her life; I never thought it was empty or purposeless. 

I talked to my friend from grad school who chose with her husband not to have kids.  She told me that the people she considered her grandparents had been a childless couple who were her neighbors growing up and she challenged me to broaden my definition of family.

I imagined the wanderlust I could indulge without having to consider school schedules and the jobs I could pursue if I stopped worrying about insurance coverage for fertility treatments or paid parental leave. 

Slowly, my future stopped feeling empty and started feeling full of potential.  I accepted a possible reality where I don’t have kids.  And now, when we are actively moving forward with surrogacy, I’m a little sad to give it up.  I liked that possible life too.  It’s still not the one I’d choose, but then again, neither is surrogacy or a one-child family.  This might not be the life I ordered, but I no longer feel stuck in it.

“This Is Not the Life I Ordered” says that in order to become the author of your own life you need the four P’s: purpose, passion, possibilities, and power.  When having kids was the only way I could define my purpose, it limited my possibilities and diminished my sense of autonomy and personal power.  By opening myself up to childless possibilities instead of resisting them, I was able to spark new passions and broadened my definition of purpose. 

Sometimes when we’re down, we don’t need people to tell us it will all work out.  Sometimes, we need people to help us hold the alternative: That things might not work out; and even if they do, it probably won’t look the way we imagine it.  But no matter what, we will be just fine

National Infertility Awareness Week 2020

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This week is National Infertility Awareness Week 2020 and as part of it, RESOLVE, the National Infertility Association started a five day photo challenge. I’ve posted the photos on Instgram and Facebook, but also wanted to share them here.

Day 1 #HonorYourStory

We all have our own fertility journey. You’ll notice that I always refer to mine as a fertility journey rather than an infertility journey, because I prefer the concept of moving towards something positive rather than moving through something negative. I also personally debate whether repeat miscarriage should fall under the bucket of “infertility” since I’ve had no trouble getting pregnant, I just have trouble staying pregnant.

My fertility journey took me through recurrent pregnancy loss (RPL) and secondary infertility (SI) which is infertility after a pregnancy. Along the way I was diagnosed with polycystic ovaries (PCOS) which is the most common cause of infertility among women. They also found I had a septate uterus (SU) which is a congenital abnormality that I had surgically removed. There were other plenty of other diagnoses along the way, but I wanted to call those out to help explain the drawing. The other acronyms are for male factor (MF) infertility, premature ovarian failure (POF), endometriosis (ENDO), and luteal phase defect (LPD) which can all be causes of infertility.

#FurBabyDay

I have two “fur babies” who current endure the role of my surrogate children, but sometimes I go too far. True story: I watch a lot of stand up comedy on Netflix, one night I watched one of Iliza Shlesinger’s specials and she did a bit about anthropomorphizing her dog. I laughed so hard because literally five minutes before that bit I had walked over to my cat, flipped him upside down, and given him a raspberry on his belly…

#WearOrange

12.5% of women struggle with infertility so RESOLVE has started the “1 in 8” campaign to create awareness of the issue. Why orange? Here is the explanation from RESOLVE’s website:

“The color orange promotes a sense of wellness, emotional energy to be shared: compassion, passion, and warmth. Helps to recover from disappointments, a wounded heart, or a blow to one’s pride. Studies show that orange can create a heightened sense of activity, increased socialization, boost in aspiration, contentment, assurance, confidence and understanding.”

#ThisIsMySupport

The past six years of my life have included some truly wonderful moments, but also the most difficult periods of my life. I would not have been able to survive (thrive?) without the support of my husband, my mom, my dad, my little sister, my therapist, and my friends Chris and Christy. These people have been my constant cheerleaders. They’ve held me while I cried, sat with me when I was sad, reassured me when I was nervous, encouraged me when I felt stuck, and listened again and again and again whenever I needed to talk. They are my lifelines.

#ShowYourRESOLVE

RESOLVE chose their name because resolve is what it takes to journey through (in)fertility, and the end of the journey looks different for all of us. Some women carry the “rainbow baby” they always dreamed of. Some take advantage of sperm donors or egg donors. Some families grow through adoption or surrogacy. And some couples choose to live without children. All of these choices take time and must me made deliberately.

RESOLVE is organizing a virtual Advocacy Day on May 20. Participants will be meeting with members of Congress to discuss access to assisted reproductive technology and other family building options. Fertility choices are so personal and so contextual. From the outside it can be easy to assume what you choose or how you would behave if faced with infertility. But I learned I can’t anticipate how I will feel about something until I am actually faced with it. So, I want to make sure that all families are able to make the choices that feel right for them.

My Second Miscarriage

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I have found it surprisingly easy to both talk about and write about my first miscarriage.  Maybe because it was the beginning of everything.  It’s easy for me to start things, to set the scene, to introduce the characters, to begin.  When I was in school, I always wrote great introductions for my papers.  Finishing things was harder.  I have a lot of half-finished projects, a lot of unrealized aspirations.  Finding a clear path through all the things that have happened since the beginning has been confusing.  Determining what parts of my story are worth sharing is difficult.  The beginning of my story lives as a crystal-clear picture in my head.  The middle of my story lives as a big jumble – a ball of tangled yarn.  And if I pull on it, I’m not entirely sure where it will go.  Still I’m determined to continue the telling.  I think it will be cathartic for me to follow the thread to the end.

After our first miscarriage, my husband and I waited two months before trying again.  This was partly based on our doctor’s recommendation and partly based on how quickly my body recovered from the D&C (it took about 6 weeks for my cycle to return).  Once again, we got pregnant quickly. 

That summer I had been travelling a lot for work and was wrapping up a major project with our team in Tokyo, so we decided to use my last business trip as an opportunity to travel through Japan.  During my final days of work, I was exhausted, and thought I might be pregnant.  I had brought one pregnancy test with me from the US.  I tried to wait to use it until after the first day of my missed period; I tried really hard.  But I have never been a particularly patient person.  When I buy new clothes, I wear them right away.  When I buy someone a gift, I want them to open it immediately.  I’m sure this says something about my need to learn to sit with feelings of anticipation or not knowing.  I probably would have failed the “marshmallow test” as a child.  Regardless, I took the test, and it was negative. 

I was disappointed, but unconvinced.  I still couldn’t shake the feeling I was pregnant. I closed out my project and we set off to explore Osaka and Kyoto.  Our first morning as tourists, I dragged my husband through several hours of trying to find a pharmacy where we could buy another pregnancy test.  I took it in the bathroom of a noodle restaurant.  This time it was positive, and I was thrilled – and terrified. 

Not the same terrified as I had been with the first pregnancy.  Not the nervous anticipation of transitioning from woman to mother.  I was terrified because I didn’t want to miscarry again.  Japan is a lovely place to travel, but I was only partially present for it.  Everything we did made me nervous.  I was afraid to do too much walking and tax my body.  I was anxious about all my meals since I wasn’t sure what Japanese food was ok to eat while pregnant.  Returning to the US was a relief. 

About two weeks later I started to spot.  I called my doctor, who told me to come in for a blood test, which revealed that my hCG levels were low.  This can indicate an ectopic pregnancy, so she scheduled me for a high definition ultrasound. 

The ultrasound was conducted in the obstetrics unit of the hospital, in the same room as the exam which had confirmed my prior miscarriage.  I hate that room, and I was expecting bad news.  I was expecting all manner of pregnancy problems.  What I was not expecting was for the ultrasound tech to say, “Actually, everything looks okay.  See, there’s the heartbeat.” Hope began coursing through my veins as rapidly as that little “Flicker” fluttered.

My husband and I left the hospital and walked across the street to the clinic to review the results with our doctor.  The nurse asked me to take a customary urine pregnancy test (why?) which suggested that I was NOT pregnant.  I tried to explain that it was because I had consumed liters of water before the ultrasound, and that I had just seen my pregnancy, but she still tried to send me home.  Ridiculous.

When we finally saw our doctor, we were a jumble of emotions.  My hCG was still low, as was my progesterone, and I was still spotting, but there had been a heartbeat.  She prescribed progesterone suppositories to support the pregnancy and told us to try as hard as we could to relax and proceed as if it was a normal pregnancy. 

I tried to calm down but found it impossible.  I didn’t want to do anything other than lie on my couch for nine months.  I was afraid that breathing too hard might impact the pregnancy.  I asked the little Flicker to hold on tightly.  I promised it we would be excellent parents.  

Several days later my spotting turned to outright bleeding.  I remember laying on the floor of our living room with my knees bent enduring waves of cramps.  They came about every 20 minutes and were always followed by a trip to the bathroom and the passing of a large clot.  I’m pretty sure I know when I passed the gestational sac.  It looked like a large grape.  I squished it in the toilet paper between my fingers.  I’m not sure why, I think I wanted to see if there was a baby inside.  Instead it just crumbled into goop – like bloody cottage cheese.  And I flushed it down the toilet.

What’s odd is that I while I knew I was miscarrying, after the bleeding stopped, there was a lingering hope in the back of my mind that everything was still ok.  I think I expected there to be more blood than there had been, so I was able to weave an elegant narrative about shedding old lining in order for my body to support a new pregnancy. After all, I hadn’t seen the baby come out – just goop.  Once again, I went down the dark and dreamy rabbit hole of Google grasping desperately at other women’s experiences: “I bled like crazy during my first pregnancy and now I have a healthy toddler;” “My hCG levels were slow to rise but now I’m 27 weeks pregnant;” and on and on; and on and on… 

A trip to the doctor a week later confirmed the complete loss.  I drove home, made myself a two-tiered vanilla cake with chocolate butter cream frosting and proceeded to eat a quarter of it.  I “worked” from home for a week while watching Ally McBeal on Netflix but had to stop when she started seeing the dancing baby.

My feelings after the second loss are painful to describe.  One loss seemed like bad luck.  One loss was common.  Sad and devastating, but common.  Two losses indicated a pattern.  Two losses confirmed my worst fears – that it was MY fault – that there was something wrong with ME.  A loss after seeing a heartbeat was uncommon.  The loss after seeing the heartbeat felt like a death.  I had been able to rationalize my first loss.  A blighted ovum almost certainly indicated a chromosomal problem – I couldn’t have controlled that – it wasn’t my fault.  But losing that little Flicker, that felt like a complete personal failing. 

Maybe the reason I’ve avoided telling this part of the story is because it’s sad.  Revisiting these memories puts a pit in my stomach and lump in my throat.  But maybe that’s also why the telling is valuable.  Extracting a sad story from our psyche is like excising a malignant tumor from our body.  The healing work continues, but we have been diagnosed.   Telling my story separates me from it and allows me to evaluate it as a specimen under a microscope.  The story is sad, but I am not sad.  I can decouple those from one another now.  Here is the harder one, the one I’m still healing from and working through:  The pregnancy failed, but I am not a failure.

What it means to be a woman

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I discovered RuPaul’s Drag Race in 2017.  I realize I was late to the party, but I have since made up for my delinquency by watching every season… multiple times. This was in the immediate aftermath of my fourth miscarriage, so I felt utterly broken and was not sure I wanted to go on trying to have a baby (or doing much else).  Remarkably, RuPaul helped curb my depression.  Apart from realizing that Drag Race is one of the best shows on television (FYI season 12 is currently airing), I recognized that the fabulous Drag Race queens were more empowered as women than I was.

Miscarriage challenged my identity as a woman.  The fact that my body would not or could not do what it was built to do made me wonder what it meant to be a woman at all.  In her book After Miscarriage author Krissi Danielsson describes it thus:

[She] may feel as if the loss took a part of her away and violated her as a woman… Because this happened in her womb, the core of her womanhood, if you will, and she wasn’t able to control it, the miscarriage might feel to her like a kind of psychological rape.

Those are very strong words that speak to the trauma of pregnancy loss, and they do resonate with me.  The UK recently published results of a study which showed that nearly 30% of women exhibit symptoms of PTSD in the aftermath of their miscarriage. 

For my own part, I stopped feeling comfortable in my own body. The medicines and medical exams felt invasive.  Progesterone made me feel dizzy, prednisone made me feel puffy and caused me to gain weight, and the enoxaparin shots left long lingering bruises on my stomach that served as a constant reminder that I was not functioning properly.  What’s more, my husband’s and my sex life was completely orchestrated by my hormone levels and ovulation dates, which left little room for desire.  The result of all this was that I felt broken, unattractive, and most definitely NOT like a sexually empowered, confident or capable woman.

During this time, I worked from home, so I spent an inordinate amount of time in pajamas.  I leaned into feelings of inconsequence: I stopped personal maintenance and exercise routines; I was aggressively unsociable; and I shied away from physical affection.  Guilt over the failure of my pregnancies transformed into feelings of unworthiness, which is how I began to define myself. 

Enter the Drag Race contestants, each of whom had overcome their own obstacles in order to pursue their dream and become a beautiful, confident queen.  Their collective courage inspired me and sparked a desire to rediscover my passion and rebuild my confidence.  RuPaul says that we are all doing drag all the time.  What he means is that we are more than our physical and material manifestations.  At our core we are spiritual beings, so the labels we use to define ourselves are simply our drag.  My drag had become pretty sad.

I wish I could tell you all it took was that realization and I was fixed, but I’m working on it.  One exercise I found helpful was when my therapist encouraged me to personify all the different aspects of my personality.  She told me to draw them and give them individual names and characteristics.  The objective was to help determine which part of me was playing the lead and which parts needed a more active role in my life.    

There’s a part of me that’s sassy and charming – she (re)started getting her nails done and it made me feel pretty and frivolous.  There’s a part of me that’s academic and contemplative – she started a book club and in doing so forced me to schedule time with girlfriends and be surrounded by female energy.  There’s a part of me that’s ambitious and assertive – she stood up for herself at work and I remembered I had free-will.  There’s a part of me that’s empathetic and tender – she recently read Self-Compassion: The Proven Power of Being Kind to Yourself by Kristin Neff.  In one of the first exercises in that book Kristin challenges you to speak to yourself as your best friend would speak to you.  My best friend is understanding, validating, supportive, encouraging and kind; she loves me.  RuPaul says, “If you can’t love yourself, how the hell you gonna love somebody else?”  I am working hard to love all the parts of myself – even the part with a misbehaving uterus.

My First Miscarriage

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My husband and I arrived at our first 8-week appointment a little frazzled, a lot anxious, and very late; but our doctor was lovely about it.  We gave him our history and talked to him about my symptoms (they were few, thankfully).  And after a bit of small talk, he said “alright, let’s see how things look.” 

He didn’t say anything for a long time after starting the ultrasound, then he asked if we were sure about our dates.  “The pregnancy,” he said, “does not look as expected for someone 8-weeks along.” He explained it was possible that our dating was wrong and that we were earlier in the pregnancy than we thought, or it was possible that this was something called a “blighted ovum” which meant that while the gestational sac had developed, the embryo never started growing.  He sent us home and told us to come back in two weeks. 

Back in our apartment, I remember sitting on the couch with my husband in silent tears.  We were in complete shock.  I had known “miscarriage” was a possibility, maybe I’d even known it was common, but I’d only ever thought about it in abstract terms, never really expecting it to happen to me.  I can’t find a good analogy.  All I can say is that I had truly believed miscarriage was something that happened to “other people,” unlucky people, older people, unhealthy people, you name it.  But. Not. Me.

It became immediately apparent to me why women don’t share the news of their pregnancy until after the first trimester.  Having to text my family and friends with whom I’d shared the news was devastating. I felt like I’d disappointed them.  Answering their questions was impossible given that I didn’t fully comprehend what was happening.  And holding their feelings was excruciating because I could barely hold my own. 

In my head I knew our dating was correct.  In my head I knew my lack of morning sickness was not a good sign.  In my head I knew this was a loss…  But my heart, oh my heart was a tricky devil.  Her denial was a powerful drug.  With her I scoured the internet to find multiple accounts of people in my situation for whom everything worked out.  With her I prayed to God and painted a beautifully hopeful picture of everything turning around.  Her strong fingers clung to those two weeks like a lifeline.  

The second ultrasound took place in the obstetrics unit of the hospital.  My husband came with me, but honestly, I have very little memory of him being there that day.  I do remember the ultrasound tech leaving the room to get her supervisor – a kind, young, male doctor, who explained as politely as he could that it was indeed a miscarriage.  I do remember sitting on the procedure table, in a dark room, naked from the waist down, and sobbing.  I do remember walking out past all the happy and rotund women in the waiting room with tear streaked cheeks feeling like a wraith. 

I didn’t want to do anything about it.  I believed that eventually my body would “do the right thing” and pass everything naturally (and maybe I even hoped that my lack of bleeding meant some medical miracle was occurring, and things would still work out just fine).  I was wrong on both counts.  At 12 weeks – 7 weeks after the pregnancy had stopped progressing – my body still thought I was pregnant.  This is called a “missed miscarriage.”

I became irrationally angry at the body I had previously trusted.  I felt like my own uterus had betrayed me.  She was so completely delusional, so wrapped up in the experience of being pregnant that she had failed to recognize the non-viable fetus.  I was disgusted with her and finally opted for a D&C. 

My husband had a conflict the day of the procedure, so my mom came with me instead.  She told me I’d be back in that hospital again someday under better circumstances, and I think I believed her.  The nurse asked me if I wanted information about support groups, and I declined.  Nearly a month had passed between my first appointment and the day of the D&C, and by that time a support group felt like too little too late.  I didn’t want to talk about it.  I was anxious to hurry up and move on.  I wanted to try again. 

The nurse also asked me if I wanted to do anything with the tissue, like have it tested or interred. Again, I declined.  I wanted nothing to do with those traitorous cells.  I just wanted them out of my body.    In retrospect, I wish I’d been in mental place to ask for testing.  My doctors and nurses were surprisingly dismissive about the loss.  It was early.  Loss was common.  Testing would most likely show that there was something wrong with the fetus, but there was no reason to believe it would happen again.  My best course of action was to keep trying.     

What I know how is that while it is true that most miscarriages are a result of chromosomal abnormalities, there are other causes.  Testing the pregnancy tissue can help with diagnosis. One study I read concluded that when testing is combined with the standard workup for repeat miscarriage, a definite or probable cause can be found for 95% of losses.  Knowing the exact cause of my losses may not have made me feel better, but it may have influenced the decisions I made about treatment options. I may not have tried some of the experimental treatments; or I may have pursued them more aggressively.  I can’t be sure.  But I’ll never know, because I didn’t ask.

Through this process I have learned to be a better advocate for myself.  I bring a family member with me to appointments because sometimes my emotions cloud my ability to listen, and I want someone there to ask questions.  I do my own research online following appointments.  I ask for referrals and read reviews of hospitals and clinics.  I don’t do this because I mistrust my doctors; I have an immense amount of respect for doctors.  But my doctors will never care as much about my health and well being as I do.  They will never know my medical history without looking at my charts.  They may be kind, and compassionate, and smart, and excellent, but they are human, and they are fallible.  I think we have a personal obligation to ask questions, seek second opinions and conduct our own research, because nobody else will do this for us.  Anyway, this is just one girl’s opinion.  Take it or leave it. 

On Letting Go of Control

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Several years ago my mom’s friend recommended I read “The Untethered Soul: A Journey Beyond Yourself.”  It’s a beautiful book about the relationship between your thoughts and emotions and your true self.  I read it after each of my last three losses, and it helped me experience my grief without being consumed by it.  I pulled it out again this week, because the Covid-19 crisis has challenged my sense my control and triggered old anxieties.  One of my first notations in the book was this line: In the name of attempting to hold the world together, you’re really just trying to hold yourself together.  It brilliantly explains the mental gymnastics I often perform to rationalize uncomfortable or inexplicable situations.     

Nowhere was this futile exercise so evident than in my fertility journey.  After every pregnancy I meticulously retraced my actions, desperately seeking a reason for the loss.  If I had a reason, then there was something I could do, something I could change in the future.  I had done everything my doctors told me, yet they could offer no clear explanations, so the only thing I could come back to was myself.  I mentally flogged myself for past misbehavior: “I should have ordered decaf;” “I shouldn’t have taken that hike;” “I should have switched to glass water bottles instead of plastic.”

I felt responsible for the outcome of my pregnancies. Because everything had happened inside of me they were so personal.  Every pill swallowed by my throat.  Every shot absorbed by my skin.  Every cramp experienced by my muscles.  Every bleed seen by my eyes and exited through my womb. Childbearing is something a woman’s body is built to do, so my inability to procreate made me feel like something essential was amiss.  I felt broken and I felt culpable.

Often people told me “it will happen when it’s meant to be.”  But rather than allaying my pain, this instead resulted in me stuck in a philosophical and theological quagmire, stewing over questions like: “Did I do something to deserve this?” or “Does God not want me to be a mother?”  I hadn’t realized that my Christian upbringing had cultivated a guilty conscience that lived in the recesses of my sanity; and I’m not even Catholic!  But there it was, this terrible fear that I somehow deserved to miscarry.  Because without clear answers to turn to, my guilt turned to shame and a pervasive feeling of unworthiness.  At least it was an explanation.

As repentance, I tried harder.  I scoured the internet for information about healthy pregnancies and modified my diet and lifestyle accordingly.  I cut out dairy, gluten and sugar and considered how every bite of food I put into my mouth would impact my blood sugar and inflammation levels.  I took a plethora of vitamins and herbs and even used essential oils.  I tried experimental medical treatments and integrated medicine.  There was little I wouldn’t consider in my efforts to get and stay pregnant.  But nothing worked.  I couldn’t fix it. 

Slowly, I started to accept that I had little to no influence over my ability to have a baby.  Even more slowly, I started to recognize that it wasn’t a personal failing. Ironically, it was a rather poignant “let go and let God” transformation realizing that I couldn’t orchestrate my life the way I wanted.  It was also the breakthrough I needed to begin dismantling my guilt and process my grief.  

The Untethered Soul says that every experience of our body is an expenditure of energy.  The energy “first tries to release by manifesting through the mind,” as it had done during my frantic search for answers, “then tries to release through the heart [which] is what creates all the emotional activity,” as it had done by wearing a mantle of shame and unworthiness.  The challenge is to allow the energy to flow rather than trying to block it or being swept away by it.  I imagine a swimmer in a river who rather than fighting against the current or riding it downstream, paddles to bank where she can wade calmly and watch the water flow.

At this point I (mostly) accept that I did nothing to cause my miscarriages and I (usually) can quiet the voice that questions my worthiness of being a mother.  But I still often wish I knew why.  Why did I lose so many pregnancies? Why couldn’t medicine figure it out?  Another line I noted in the book says: The truth is that most of life will unfold in accordance with forces far outside your control, regardless of what your mind says about it … there is no reason to constantly attempt to figure everything out.  With that in mind, the only thing I can do is continue to sit with this discomfort, and not let it keep me from moving forward.   

Loss Anniversaries

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This week marks the anniversary of my sixth and most recent miscarriage.  

The pregnancy was realized through a round of IVF using a genetically pre-screened embryo.  When I learned the implantation took, I was so excited and nervous that I put myself on voluntary lock-down (not unlike the social distancing I’m currently practicing).  I refused to travel for work or do anything strenuous.   My levels looked great, and I began experiencing the wonderful bouts of nausea and exhaustion common to early pregnancy. 

At seven weeks I started to bleed and became terrified.  We went to the doctor to figure out what was wrong, but they couldn’t find any source of the bleed.  Instead, they showed us a perfect little heartbeat on the ultrasound and told us to rest easy.  We went home shaken and confused but happy and hopeful.  The bleeding stopped.

Two weeks later, at nine weeks, at the final appointment before I would ‘graduate’ from specialty care back to a normal ObGyn, we were told the embryo had stopped growing.  The heartbeat was gone.

I knew immediately that I was done.  I couldn’t take any more.  I would not go through this again. 

My doctor, who is lovely, told me it wasn’t my fault.  She said we’d done everything we could.  When I switched to her care after my 4th loss, I’d told her I didn’t have much left in me, but she was encouraging and said there were still things we could try.  That day we learned about the 6th loss, she said while she still firmly believed I was capable of carrying a pregnancy, she supported me in moving on to other options.  I think she could see and sense my utter exhaustion. 

Because the lab screened the embryos, they knew the gender; and because I have little patience and am terrible with surprises, I opted to know.  It was a girl.  In my head I had named her Laurel.  

I gave myself more space to grieve than I had after prior losses, maybe because I knew it was the last time.  I took a full week off work – like OFF WORK.  My husband found an AirBNB at the beach and we spent the next few days watching the ocean, eating seafood, and simply being together. It was actually a really nice trip. 

My memory over the past years is littered with similar and otherwise wonderful events remembered through the lens of my pregnancies:

  • Our 10th college reunion which we attended during the 2-week period in our first pregnancy when we were waiting to see if it was progressing normally. 
  • The trip I took to Orlando with my sister and mom for her 60th birthday, after we learned our first pregnancy was indeed a miscarriage.
  • Wandering together through Osaka, Japan trying to find a pregnancy test to confirm the start of our second pregnancy, and our subsequent celebration in Kyoto when we learned we were.
  • Attending Riot Fest in Chicago during our second miscarriage, after I started bleeding but before our doctor could definitively confirm a loss.
  • Driving cross-country with my husband when we moved from Chicago to Seattle and attempted timed intercourse with a trigger shot to conceive our third pregnancy.
  • Hiking Mount Robson in Canada in the aftermath of our fifth loss.

These memories aren’t bad; they’re good.  I was with friends, or family, or in foreign countries, or at fun events.  But it’s as if there’s a scratch on the lens blocking certain shapes and distorting certain angles.  They are all slightly marred.  And, of course, I have sad memories too.

Anniversaries of losses can be hard, so can intended due dates, so can places or activities associated with the losses.  Mothers’ Day can be particularly challenging. Receiving birth announcements and baby shower invitations can trigger sadness. 

All I can do in these moments is honor my pain and practice self-care.  Yesterday I made chocolate chip cookies and ate about 10 of them.  I went back and looked through pictures from our trip to the beach.  I talked to my husband about our losses and our journey.  I journaled.  I wrote this post. And I’m still sad. 

Next year at this time, it will probably be better. I have two quartz stones on my bookshelf.  One is from the Himalayas.  It is jagged with sharp edges.  The other is from a beach in western Washington.  It is perfectly smooth and round.  They are my reminder that time changes us.  It blunts our corners and heals our wounds.  This too, shall pass.

“Good Grief!”

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My sister’s friend lost her father two weeks after I lost my fourth pregnancy.  He developed a relatively rare cancer, and though he fought valiantly, died much too young.  I felt so sorry for her.  I am close to my father, as was she, so I could easily imagine her heartbreak.  I also felt like she was more entitled to grief than I was.  Afterall, she was grieving 30-some years of memories of her father.  She lost a fully actualized person.  I hadn’t lost a person – no person existed.  I didn’t feel like I should hurt.

I have often blamed my company or society for urging me out of my sadness too quickly, and maybe that’s true, but I also wanted to move on and put it behind me.  It hurt.  Mentally.  Physically.  Grief is uncomfortable.  I didn’t necessarily want to forget what happened, but I wanted to prune the pain from the tree of my psyche as quickly as possible.

One of the mechanisms I used to try to motivate myself out of pain was self-talk.  But instead of being compassionate, my inner voice tended towards judgement and tough love.  I would remind myself of all loss in the world; people who have lost their homes because of war, people who have been disabled by injury, people who are dealing with terminal illnesses, people who have lost parents or spouses, people who have lost children. Thus, instead of feeling better, I would end up feeling like these people deserved grief more than I did.  Since my pregnancies lasted only a few weeks, the magnitude of my sadness did not feel commensurate to the length of my experience.  I felt melodramatic and ashamed of my grief.  It made me wonder if I was weak or out of touch.

What I was really grieving, what I still am grieving, is the loss of a future I had envisioned.  Yet in this way, my grief was similar to that of my sister’s friend.  I had no memories to mourn, but we were both robbed of futures we wanted.  She lost future holidays with her father and the ability to have him walk her down the aisle at her wedding.  I lost the ability to hold the children I never met, the family vacations I imagined, the possibility of them.  In different ways, we were both grieving the absence of something in our future, something we cared about and wanted. 

I am not saying that the loss of a pregnancy is the same as the loss of a parent, or a partner, or a child.  Or the loss of one’s own health due to sickness or injury.  Or the loss of one’s home due to war or economy. But the themes of grief are common regardless of circumstance:  

Outrage that something you cared about has been taken from you unjustly. 

Anger that the future will no longer look the way you want it to.

Anguish about the loss itself. 

Hurt from the trauma that may have been endured physically or mentally.

Remorse over feelings that you could have done something sooner or better that may have resulted in a different outcome. 

It’s really hard to not have your life work out the way you want it to. It’s really hard to know that no matter how hard you try there are things you simply cannot control.  These feelings are hard for everyone, they just manifest themselves through different circumstances in our lives.  Trying to comfort me after my losses, people would remind me of all the great things I had going in my life.  I did.  I still do.  But gratefulness and grief are not mutually exclusive. 

Beneath the umbrella of infertility and pregnancy loss there is comparative judgement of pain.  Women who experience secondary infertility are told to be grateful for the children they have when they try and fail to grow their family.  I was told to be grateful for my ability to get pregnant when other women couldn’t.  When I had one loss, I was told stories of women who’d had multiple losses.  When I spoke of early losses, I was told about women who’d had later losses or stillbirths. The message in all these situations is the same “be grateful for what you have, someone hurts worse than you.”

But we don’t have to act this way.  We don’t need to determine who hurts the worst before determining how much kindness they’re due.  Placing someone’s loss in relative perspective of other losses does not remove their grief.  Instead, we can empathize with the experience of grief, which we all have felt or will feel at some point.  In this common theme, we can find the compassion for others and for ourselves. 

I Get By With A Little Help

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Many women struggle to talk about their experience of miscarriage, in part because many women don’t share the news of their pregnancy before the loss.  But I also think it’s because as humans, admitting we’re in pain puts us in a position of vulnerability, and that feels uncomfortable and threatening.  I felt isolated and ashamed.  Nobody within my immediate circle had lost a pregnancy so I constantly wondered if I’d done something wrong.  My close friends and family were reassuring and supportive, but when my grief lingered beyond a few weeks, I became afraid of sounding like a wet blanket; I worried they would tire of holding my sadness, and then not want to be around me.  So, I suppressed my feelings and put on a happy face.  As a result, I felt inauthentic because I was hiding this huge aspect of my life from many of my friends and nearly all my colleagues.  There is a Rumi poem called “Cry Out in your Weakness” and several stanzas now resonate with me:

Give your weakness
to one who helps.

Crying out loud and weeping are great resources.
A nursing mother, all she does
is wait to hear her child.

Just a little beginning-whimper,
and she’s there.

God created the child, that is, your wanting,
so that it might cry out, so that milk might come.

Cry out! Don’t be stolid and silent
with your pain. Lament! And let the milk
of loving flow into you.

I like this idea of giving my weakness to those who can help.  Grief is a heavy burden to carry alone, we need others lighten the load.  For some, this support comes from friends and family, for others from online communities or support groups, for me it largely came from therapy.  I currently have two therapists.  One for me and one for my marriage.  

My mom is the Executive Director of a counselling center outside Chicago and I’ve dealt with mental health issues (anxiety and depression) since young adulthood, so for me, therapy was an obvious option. Even so, I had to overcome self-judgement to set up the first appointment.  I wanted to be stolid and silent with my pain.  I was frustrated with myself for continuing to be sad about my losses, and I didn’t want to admit I needed support.  Seeking help is often stigmatized in our society.  It feels weak and it can be awkward to share your feelings with a stranger.  If you want to try therapy, but are wary, here is my advice:

  1. Have an introductory conversation with the person before you book an appointment.  Tell them what you’re going through and what you’re looking for.  Ask them if they have experience with the types of issues you’re facing and if they think they can help you.  And, if that conversation doesn’t go well, then don’t make an appointment with that person. 
  2. Give it three sessions.  If you don’t feel a connection in three sessions, break it off and find someone else. Do not waste time with someone who won’t work for you.   You can even say up front that you want to have a check-in after three sessions to make sure it’s a good fit.  A good therapist should agree to this.
  3. Don’t think it’s like on TV.  Yes, we all want that breakthrough moment like Matt Damon had with Robin Williams in “Good Will Hunting” but it doesn’t work that way.  Therapy takes time and work.  Sometimes a session will be helpful and move your forward, but then the next session feels stagnant and unhelpful.  Adopt the long view.

Grief comes in waves and sometimes even when you think you’re totally fine, something happens that lands you back on your ass in tears.  I’ve had several friends recently lose pregnancies.  I’m not sure any of them would have confided in me had they not known about my own experience, and I’m grateful and honored to have heard their stories.  I’ve told them all the same thing:

Be patient and kind with yourself.  This is not your fault and there’s nothing you could have done to prevent it.  What you’re going through sucks.  It feels unfair.  It can make you feel sad, angry, or jealous.  These feelings are ok.  They don’t make you a bad person or mean that you’re ungrateful or lack perspective.  They’re just feelings.  Cry out and share them. 

In the Beginning…

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My husband and I have been together a long time.  We met in college and got married when we were 26.  We were ambitious young professionals who enjoyed our independence.   We traveled a lot on the weekends and socialized a lot in the evenings.  We didn’t want to be young parents.  Besides, people in our generation were having kids later these days anyhow, right? Right??? 

Sometimes I wonder if I had known then, what I know now if I would have done anything differently.  I’m honestly not sure.  

In any case, we matured from our 20’s and turned to family planning.  We started trying in January 2015. My husband was in grad school and I had a good job. We were living by family back in Chicago.  We were finally “ready.”  

I distinctly remember the first time we tried to get pregnant.  For so many years we’d been focused on prevention. The change was exhilarating.  Afterwards, we looked sideways at each other wearing expressions like those of guilty teenagers.  We felt hopeful, anxious, and in love.  We were embarking together on mysterious journey into the void and towards our future.

We got pregnant quickly, after only two months.  My husband was on a school trip and I was coming back from a business trip, so we weren’t even together when I found out.  I wasn’t expecting to be pregnant, so when I took the test by myself, I was completely shocked to see it turn positive.  My husband was equally dumbfounded.  We were accustomed to stories of friends trying for months and months, and yet here we were having success so quickly.  We felt lucky, and terrified.

We immediately and rather rashly told family and close friends. Everyone was thrilled.  My sister sent me pregnancy books and my friends shared first trimester tips.

I dove headlong into the world of expectant mothers.  I bought all sorts of healthy foods at the grocery store as well as ginger snacks and other nausea fighting foods.  I downloaded a pregnancy app on my phone and made a daily ritual of reading about the developments that were happening inside me week by week.  In my free moments I would scroll through lists of baby names.  I started planning the next year of life in my head, pre-cancelling trips and adjusting holiday schedules.  

That was a happy time. Hand to God, I still remember those first weeks with a smile even after everything that happened. 

It’s five years later now, and with each pregnancy I got a little less excited and a lot more terrified. 

I have a friend who also experienced recurrent miscarriages.  Her husband visited us while she was pregnant for the 4th time with their now son.  He said in those first few weeks, before they knew the pregnancy was progressing normally, they referred to it as “dead baby.”  We had only had one loss at that time, and I remember feeling uncomfortable thinking about much pain they must have endured to become so cynical.   Now I get it. 

At the start of my second pregnancy I re-downloaded the app and took all the pregnancy books out of the drawers where I’d stashed them away during my prior pain.  I still felt enthusiastic.  I thought I was once unlucky and would go on to have a perfectly normal pregnancy.  By my third loss however, my expectation shifted, and every time the pee-stick turned positive, I simply assumed it would end poorly.  I waited to make first appointments because it felt so terrible to have to call back and cancel them.  I donated the pregnancy books.  I still always told my family, but I usually told them via text, because I couldn’t handle hearing the excitement that they were somehow able to hold for me.  I remember telling my mom once over the phone; I said I was pregnant and then immediately burst into hysterical sobbing.  It’s not that I wasn’t happy, but my fear was so overpowering that I could barely stand it.

The truth is that even for women who’ve had multiple losses, the chances that her next pregnancy will be successful are still higher than chances she’ll lose it.  That’s why doctors tell women to keep trying, and that’s why all sorts of stories exist of women having six, seven, ten losses and then a healthy baby. 

But it’s hard to keep getting back on the horse.  It feels impossible and insane.  My therapist once asked me to draw a picture of what it felt like to keep trying and I drew a person trying to climb a mountain while simultaneously working to drag an anchor up from the depths of the ocean.

If this is you, try and be kind to yourself.  I won’t tell you that it will all work out the way you want, because I can’t promise that it will.  But I will tell you that we can both find a way for life to be OK regardless. I keep two cards on my desk at all times.  One is from my mother and reads “Life is tough, my darling, but so are you.” The other is from my best friend and reads “You are BRAVE, you are STRONG, you are LOVED.”